The Rhomboid Flap

Described by Limberg in 1966, also known as the Limberg flap, random pattetn flap, used anywhere where tissue laxity can be identified. (classically Temple)

Books talk about lines of maximum extensibility and relaxed skin tension lines… it’s a load of confusing crap, too much waffle. Once a genius explained this to me in 2 minutes before he did it on someone’s temple and I get it now…

Thank you AN!!

1) Identify the lesion

2) Draw/imagine where the wrinkles on the  skin lie

3) Draw two two lines parallel to each other and 90° to the wrinkles.

4) Join the other lines to make a rhomboid

5) Extend a line from the biggest angle to make the 4 potential flaps

6) On face chose an inferiorly based flap to get a flat surface (need the blood and lymph and stuff) to get drained away. Superiorly based flaps are used for projection, e.g nipple.

7) Always close the donor site first to release tension.